Condoms are more effective when applied by males: a study of young black males in the United States

PurposeTo determine, among a sample of young black male (YBM), whether female application of male condoms for penile–vaginal intercourse would be associated with higher or lower rates of breakage or slippage. A secondary aim was to investigate if higher rates of breakage or slippage were associated with increased odds of acquiring chlamydia and/or gonorrhea.MethodsA cross-sectional study of 412 YBM, aged 15 to 23 years, was conducted in three US cities located in the Southern United States.ResultsAmong YBM reporting frequent female application of condoms, 43.5% reported one or more instance of breakage or slippage, compared with those reporting less frequent female application (27.2%, P = .003). Among YBM reporting one or more event of breakage or slippage, 25.4% tested positive for chlamydia and/or gonorrhea. In contrast, among those not reporting breakage or slippage, 17.2% tested positive (P = .047).ConclusionsFindings suggest that educational and behavioral interventions should seek to improve young women's skills relative to condom application and use. Further studies could also investigate whether intervention efforts should encourage some YBM to be responsible for their own condom application

Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse

The original publication is available at www.springerlink.comPeer reviewedPostprin

Women's Sexual Desire: Challenging Narratives of "Dysfunction"

Recent changes in the classification of female sexual dysfunction in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the US Food and Drug Administration’s (FDA) approval of the first drug to treat low sexual desire in women (flibanserin) have highlighted the intense focus on sexual desire problems in women. We first discuss the rationale for the DSM changes and outline the DSM-5 criteria for Female Sexual Interest/Arousal Disorder. We provide an overview of some of the key events leading up to the approval of flibanserin for the treatment of hypoactive sexual desire disorder in women, including the role of the “Even the Score” advocacy campaign, that accused the FDA of gender bias in not giving women with sexual desire problems access to treatment options. Incorporating narratives from testimonials of female patients attending the 2014 FDA Patient-Focused Drug Development Public Meeting, we examine some of the prevalent beliefs around sexual “normalcy” and the immutability of sexual desire. We critique how the media and pharmaceutical companies depict sexual norms and female sexual desire and how pharmaceutical trials often narrowly define and assess sexual desire and “sex.” We end with some recommendations for how researchers, clinicians, and journalists can better acknowledge that sex and desire have multiple meanings and interpretations with a view to women being offered a truly informed choice when seeking help for sexual problems

Reasons for incomplete STI vaccination among men who have sex with men in an English sexual health service

BackgroundIn England, vaccination for human papillomavirus, hepatitis A, and hepatitis B is recommended for men who have sex with men (MSM). However, uptake is sub-optimal and some men do not complete all recommended vaccine doses. This service evaluation aimed to explore reasons for lack of uptake for each of these vaccines among MSM in one English sexual health service and to inform improvements in service delivery to increase full dose completion rates. MethodsMSM, ≥18 years, who had previously attended NHS Solent Sexual Health for at least one vaccination, and who had not completed the full dosing regimen for at least one of these vaccines, were invited to participate in an anonymous, online survey between 14/12/2020-11/04/2021. ResultsAmong 246 MSM (M = 42.1 years), the most common reason for non-vaccination was that participants thought it was unneeded and had not been recommended by a doctor or healthcare provider. None reported vaccine hesitancy. Likewise, the most common reasons for vaccination were doctor/healthcare provider recommendation (51.7–65.6%) and self-protection (60.9–68.1%). The most common reason for not having completed the full course of vaccination was being unaware that the next dose was due (30.0–37.8%). Many participants who had not completed vaccination indicated that a doctor/healthcare provider recommendation would be a motivating factor and that reminder messages and being able to book subsequent appointments in advance would facilitate vaccination. ConclusionsSexual health clinicians should be encouraged to discuss STI vaccination with MSM and services should explore possibilities to improve ease and access to vaccine appointments to increase uptake and completion rates

Raising awareness of anaerobic digestion in the UK - Views of key stakeholders

This is the open access PDF version of an article published in Journal of Environmental and Ecology© 2014.Meeting rising energy demand and sustainable development goals at the same time is a major challenge for policy makers in the 21st century. The situation is further stressed by a rising world population, climate change, natural disasters and food security concerns. Renewable energy technologies such as anaerobic digestion (AD) proffer one solution for policy makers to overcome some of the challenges to sustainable development. The technology has been widely adopted in some parts of Europe (e.g. Germany, Denmark, Austria and Sweden), the United States and also parts of Asia and Africa. However in the United Kingdom (UK), the technology is under-developed, as was recognised in its anaerobic digestion strategy and action plan of 2011. This study focused on identifying options for raising awareness of AD technology in the UK. 21 key stakeholders divided into groups according to their expertise, were interviewed to explore their views on the areas of focus in the UK strategy and action plan regarding raising awareness of the technology. The results revealed that aligning AD with sustainable development goals, community AD and localism, small AD plants, provision of an available market for AD products, building UK skills and diversifying biogas use from AD are positive options for raising awareness of AD in the UK. Challenges to these options and possible solutions to the challenges were also identified and discussed

The role of anaerobic digestion in achieving soil conservation and sustainable agricultural development in the UK.

Anaerobic digestion represents one form of renewable energy technology but has many wider benefits. This paper reviews the processes involved in anaerobic digestion, the type of systems in place and the use of digestate to improve soil quality. A case is made for the technology in the UK in the context of soil conservation and sustainable agricultural production. Its broader contribution to sustainable development in the United Kingdom is also considered. Low levels of awareness of the benefits of anaerobic digestion, poor access to funds, inadequate incentives, an unfavourable legislative and policy framework for the technology, limited application of digestate for agricultural purposes and the need for further research on digestate use are identified as key factors hindering uptake of the technology. Anaerobic digestion is presented as a technology that can support soil conservation and sustainable agricultural development while also generating both energy and income, enhancing waste and nutrient recycling and promoting environmental protection

Does attractiveness influence condom use intentions in heterosexual men? An experimental study

Objectives: Judgements of attractiveness have been shown to influence the character of social interactions. The present study sought to better understand the relationship between perceived attractiveness, perceived sexual health status and condom use intentions in a heterosexual male population.Setting: The study employed an electronic questionnaire to collect all data, during face-to-face sessions.Participants: 51 heterosexual, English-speaking men aged between 18 and 69?years.Outcome measures: Men were asked to rate the attractiveness of 20 women on the basis of facial photographs, to estimate the likelihood that each woman had a sexually transmitted infection (STI) and to indicate their willingness to have sex with or without a condom with each woman.Results: The more attractive a woman was judged to be on average, the more likely participants would be willing to have sex with her (p<0.0001) and the less likely they were to intend to use a condom during sex (p<0.0001). Multivariate analysis revealed that higher condom use intentions towards a particular woman were associated with lower ratings of her attractiveness (p<0.0005), higher ratings of her STI likelihood (p<0.0001), the participant being in an exclusive relationship (p=0.002), having a less satisfactory sex life (p=0.015), lower age (p=0.001), higher number of sexual partners (p=0.001), higher age at first intercourse (p=0.002), higher rates of condomless sex in the last 12?months (p<0.043) and lower confidence in their ability to assess whether or not a woman had an STI (p=0.001). The more attractive a participant judged himself to be, the more he believed that other men like him would engage in condomless sex (p=0.001) and the less likely he was to intend to use a condom himself (p=0.02).Conclusions: Male perceptions of attractiveness influence their condom use intentions; such risk biases could profitably be discussed during sex education sessions and in condom use promotion interventions

Condom-Associated Erection Problems: A Study of High-Risk Young Black Males Residing in the Southern United States

Previous research indicates that young men may experience condom-associated erection loss and that these problems may lead to inconsistent or incomplete condom use. The primary aim of this study was to assess, using a retrospective recall period of 2 months, correlates of condom-associated erection problems among young Black men attending sexually transmitted infection (STI) clinics. Data were collected in clinics treating patients with STIs in three southern U.S. cities. Males 15 to 23 years of age who identified as Black/African American and reported recent (past 2 months) condom use were eligible. A total of 494 men participated. Nineteen percent reported that condom-associated erection problems during condom application occurred at least once, and 17.8% indicated erection difficulties occurred during sexual intercourse at least once in the past 2 months. Multivariate analyses identified that condom-associated erection problems were associated with reports of sex with more than one partner during the recall period, reported problems with condom fit and feel, lower motivation to use condoms, and attempts at condom application before having a full erection. Findings suggest that clinic interventions should address possible condom-associated erection problems among young Black men who are at risk of STIs. Encouraging men who may be vulnerable to erection loss when condoms are used to allow sufficient time for sexual arousal to build may be an effective strategy